Gostyńska Aleksandra, Stawny Maciej, Dettlaff Katarzyna, Jelińska Anna
Department of Pharmaceutical Chemistry, Poznan University of Medical Sciences, 6 Grunwaldzka, 60-780 Poznań, Poland.
Pharmaceutics. 2019 Dec 27;12(1):27. doi: 10.3390/pharmaceutics12010027.
Co-infusion of parenteral nutrition (PN) and other drugs increases the risk of the interaction between drug and PN admixtures that can cause embolization of small blood vessels, resulting in potentially fatal consequences, including pulmonary embolism, or liver and retina vascular damage. The present study aimed to determine the compatibility between ciprofloxacin (CF) and eighteen compounded PN admixtures in order to assess the possibility of their co-administration via Y-sites.
CF and PN admixtures were mixed at two volume ratios (1:1 and 2:1) and potential interactions were examined using visual inspection, and measurements of pH, osmolality particle size, and zeta potential. The analyses were conducted immediately after sample preparation and after four hours of storage.
The compatibility tests showed that the addition of the CF to the PN admixtures did not cause any color change or sign of destabilization in the fat emulsion. However, precipitation was observed in formulations containing higher CF concentrations and, in the case of lower CF concentrations, in formulations containing magnesium and calcium ions at a molar ratio of 2:1.
The administration of CF and PN admixtures via the Y-site should be avoided or performed only with PN admixtures for which compatibility has been confirmed and the CF concentration in samples is 1 mg/mL at a molar ratio of magnesium to calcium ions of 1:1.
肠外营养（PN）与其他药物联合输注会增加药物与PN混合液之间相互作用的风险，这可能导致小血管栓塞，产生包括肺栓塞、肝和视网膜血管损伤等潜在致命后果。本研究旨在确定环丙沙星（CF）与18种复方PN混合液之间的相容性，以评估通过Y型接口联合给药的可能性。
CF与PN混合液按两种体积比（1:1和2:1）混合，通过目视检查、pH值、渗透压、粒径和ζ电位测量来检测潜在的相互作用。分析在样品制备后立即进行，并在储存4小时后进行。
相容性试验表明，向PN混合液中添加CF未导致脂肪乳剂出现任何颜色变化或不稳定迹象。然而，在CF浓度较高的制剂中观察到沉淀，在CF浓度较低且镁离子与钙离子摩尔比为2:1的制剂中也观察到沉淀。
应避免通过Y型接口同时输注CF和PN混合液，或者仅在已确认相容性的PN混合液且样品中CF浓度为1mg/mL、镁离子与钙离子摩尔比为1:1的情况下进行。
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